Infection by HCV (family Flaviviridae, genus Hepacivirus), the cause of most cases of non-A, non-B viral hepatitis, is a major cause of chronic hepatitis, resulting in liver cirrhosis and hepatocellular carcinoma worldwide146 and infects 175 million people globally. More than 80% of infected patients develop chronic disease while remaining essentially asymptomatic.147 In the United States, an estimated 2 to 3 million people are currently infected and more than 150,000 new cases of HCV infection occur per year. The sequelae of HCV-induced and serious chronic liver disease result in 8,000 to 10,000 deaths annually.147 Since the first report of viral genomic sequences from HCV in 1989, a greater understanding of the HCV infection has been achieved.
HCV infection usually develops after direct blood-borne percutaneous exposure. High risk of HCV infection has been reported often after blood transfusion.148 Epidemiologic evidence exists for the transmission of HCV to renal dialysis patients, among intravenous drug users, during heterosexual sex, from mother to baby, and even by needle-stick victims.149 With anti-HCV screening tests for blood donors, advanced assay techniques (eg, RT-PCR and in situ hybridization) have made it possible to detect early infection before the progression to acute disease.
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